Clinical implication of psoas muscle mass measurement for predicting death within 3 months in patients with incurable uterine cervical or corpus malignancy

2021 ◽  
Author(s):  
Hiroyuki Kurosu ◽  
Yukiharu Todo ◽  
Ryutaro Yamada ◽  
Kaoru Minowa ◽  
Tomohiko Tsuruta ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Muscle Mass ◽  
Cancer Cachexia ◽  
Mass Measurement ◽  
Characteristic Curve ◽  
Lumbar Vertebra ◽  
Psoas Muscle ◽  
Data Set ◽  
Cutoff Value ◽  
Computed Tomography Images

Abstract Objective The aim of this study was to find a clinical marker for identifying refractory cancer cachexia. Methods We analyzed computed tomography imaging data, which included the third lumbar vertebra, from 94 patients who died of uterine cervix or corpus malignancy. The time between the date of examination and date of death was the most important attribute for this study, and the computed tomography images were classified into >3 months before death and ≤ 3 months before death. Psoas muscle mass index was defined as the left–right sum of the psoas muscle areas (cm2) at the level of third lumbar vertebra, divided by height squared (m2). Results A data set of 94 computed tomography images was obtained at baseline hospital visit, and a data set of 603 images was obtained at other times. One hundred (16.6%) of the 603 non-baseline images were scanned ≤3 months before death. Mean psoas muscle mass index change rates at >3 months before death and ≤3 months before death were −1.3 and −20.1%, respectively (P < 0.001). Receiver operating characteristic curve analysis yielded a cutoff value of −13.0%. The area under the curve reached a moderate accuracy level (0.777, 95% confidence interval 0.715–0.838). When we used the cutoff value to predict death within 3 months, sensitivity and specificity were 74.0 and 82.1%, respectively. Conclusions Measuring change in psoas muscle mass index might be useful for predicting cancer mortality within 3 months. It could become a potential tool for identifying refractory cancer cachexia.

Simple Age Specific Cutoff Value for Sarcopenia Evaluated by Computed Tomography

2017 ◽  
Vol 71 (3-4) ◽  
pp. 157-163 ◽  
Author(s):  
Ji Sun Kim ◽  
Won Young Kim ◽  
Hyun Kyung Park ◽  
Myung Chun Kim ◽  
Woong Jung ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Skeletal Muscle ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Psoas Muscle ◽  
Health Screening ◽  
Healthy Adults ◽  
Cutoff Value ◽  
Cutoff Values ◽  
The Mean

Objective: Until now, cutoff values of low skeletal muscle mass using computed tomography (CT) were driven by optimal stratification to predict mortality in cancer patients. The aim of the present study was to investigate the simple, age-specific, cutoff value of low skeletal muscle mass by CT in healthy adults. Design: This is a retrospective, observational, single-center study. Setting: This study was performed in the health screening department of a university-affiliated hospital during a 10-year period. Patients: Medical records of 1,422 patients presenting to the health screening department were reviewed. Cross-sectional area of psoas muscle at the level of the third lumbar vertebra on abdominal CT was measured and adjusted by height (mm2/m2). This value (psoas muscle index [PMI]) was assumed to represent whole skeletal muscle mass. We divided the patients according to age, sex, and defined cutoff value of low skeletal muscle mass as 2 SDs below the mean. Intervention: None. Measurements and Main Results: Among 1,422 patients, 550 patients (38.6%) were male. The mean PMI was 896.60 (mm2/m2) for men and 570.54 (mm2/m2) for women. Cutoff values of PMI for men were 592.3 mm2/m2 for 20-39 years, 474.0 mm2/m2 for 40-49 years, 422.2 mm2/m2 for 50-59 years, 374.4 mm2/m2 for 60-69 years, and 331.5 mm2/m2 for 70-89 years. The values for women were 399.9 mm2/m2 for 20-39 years, 287.7 mm2/m2 for 40-49 years, 242.5 mm2/m2 for 50-59 years, 220.4 mm2/m2 for 60-69 years, and 147.6 mm2/m2 for 70-89 years. Conclusions: Cutoff values of low skeletal muscle mass using CT differed in healthy adults as age increased. Further studies on the effect of sarcopenia intervention using this cutoff value are needed.

The greater tuberosity radius ratio: maybe a new predictor in diagnosis of rotator cuff tear

2020 ◽  
Author(s):  
Qi Ma ◽  
Changjiao Sun ◽  
Pu Liu ◽  
Sha Wu ◽  
Xu Cai
Keyword(s):  
Computed Tomography ◽  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Roc Curve ◽  
Radius Ratio ◽  
Rotator Cuff Tears ◽  
Cutoff Value ◽  
Greater Tuberosity ◽  
Cuff Tear ◽  
Computed Tomography Images

Abstract Background The role of the greater tuberosity of humerus in subacromial impingement should be of equal important as the acromion. In this study we concerned on the morphological characteristics of the greater tuberosity of humerus and proposed the greater tuberosity radius ratio (GTRR) as a new predictor for the diagnosis of rotator cuff tear. We hypothesized that a larger value of the GTRR could increase the risk of developing rotator cuff tear. Methods This was a retrospective study and clinical data and preoperative computed tomography images of the patients with rotator cuff tears (defined as the RCT group, simple size: 61) or without rotator cuff tears (defined as the control group, simple size: 56) were collected. Three-dimensional models of shoulders were established by multiplanar reconstruction of computed tomography scans. In a standard anteroposterior view, the radius of the best-fit circle of the humeral head (the r) and the radius of the concentric circle passing through the most superolateral edge of the greater tuberosity (the R) were measured for each shoulder. The ratio of R and r (R/r) was defined as the greater tuberosity radius ratio (GTRR). Independent samples t tests were used to find significant differences within the r, the R and the GTRR between groups. Receiver operating characteristic (ROC) curve based on the values of GTRR was performed to determine an applied cutoff value which may be useful in clinical practice. Results There was no significant difference in the values of r or R. However, the mean values of GTRR were 1.339 ± 0.143 (range, 1.087–1.684) and 1.244 ± 0.172 (range, 1.040–1.706) in the two groups respectively (p = 0.002). According to the ROC curve, an optimized cutoff value of GTRR was determined as 1.262, whose sensitivity was 72% and specificity was 65% for diagnosis of rotator cuff tear. Conclusion The greater tuberosity of humerus contributes to the mechanisms of rotator cuff tear. The greater tuberosity radius ratio is recommended as a new predictor for diagnosis of rotator cuff tear, with an optimized cutoff value set as 1.262.

scholarly journals Comprehensive stereological assessment of the human lung using multiresolution computed tomography

2020 ◽  
Vol 128 (6) ◽  
pp. 1604-1616
Author(s):  
Dragoş M. Vasilescu ◽  
André B. Phillion ◽  
Daisuke Kinose ◽  
Stijn E. Verleden ◽  
Bart M. Vanaudenaerde ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Reference Data ◽  
Human Lung ◽  
Three Dimensional ◽  
Small Airways ◽  
Data Set ◽  
Computed Tomography Images ◽  
Human Lungs ◽  
Random Samples ◽  
Microscopy Images

Stereology has been the gold standard to quantify the three-dimensional lung anatomy using two-dimensional microscopy images. However, such techniques are labor intensive. This study provides a method that applies stereology to volumetric computed tomography images of frozen whole human lungs and systematic uniform random samples. The method yielded a comprehensive data set on the small airways and parenchymal lung structures, highlighting morphometric sex differences and providing a reference data set for future pathological studies.

Effect of sarcopenia on prognosis of patients with gastric cancer.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 192-192
Author(s):  
Shiro Iwagami ◽  
Hideo Baba
Keyword(s):  
Gastric Cancer ◽  
Muscle Mass ◽  
Proximal Gastrectomy ◽  
Disease Free Survival ◽  
Lumbar Vertebra ◽  
Psoas Muscle ◽  
Cancer Specific Survival ◽  
Preoperative Ct ◽  
The Impact ◽  
The Relationship

192 Background: Recently, some studies reported the correlation between low skeletal muscle mass (sarcopenia) of patients with cancer and poor prognosis. There were no reports mentioned the relationship of sarcopenia to patients with gastric cancer. Objective: To evaluate the impact of sarcopenia on survival of patients with gastric cancer. Methods: From April 2005 to December 2010, 243 patients with gastric cancer underwent gasrectomy. Patients were divided in two groups, sarcopenia and nonsarcopenia group. Sarcopenia was defined as muscle mass below the median on preoperative CT scan. Muscle mass was assessed by psoas muscle density and total psoas area. The third lumbar vertebra (L3) was chosen as the standard landmark. We examined the relationship between sarcopenia and overall survival (OS), cancer specific survival (CSS), and disease free survival (DFS). Results: The mean age was 67.6 years old. 95 patients underwent total gastrectomy, 150 did distal gastrectomy, and 18 did proximal gastrectomy. The number of laparoscopic surgery was 62 cases. The CSS and DFS of patients in sarcopenia group were significantly shorter than nonsarcopenia group (p=0.012, p=0.023). The OS of sarcopenia tented to shorter (p=0.12). Conclusions: The presence of sarcopenia was found to significantly increase a patient’s risk of gastric cancer.

scholarly journals Assessment of Muscle Quality and Quantity for the Diagnosis of Sarcopenia Using Mid-Thigh Computed Tomography : A Cohort Study

2020 ◽  
Author(s):  
Hiroki Oba ◽  
Yasumoto Matsui ◽  
Hidenori Arai ◽  
Tsuyoshi Watanabe ◽  
Hiroki Iida ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Muscle Strength ◽  
Muscle Mass ◽  
Physical Performance ◽  
Motor Function ◽  
Mass Measurement ◽  
Muscle Quality ◽  
Cross Sectional ◽  
Skeletal Mass ◽  
Low Mass

Abstract BackgroundPreviously, sarcopenia was diagnosed based on walking speed, grip strength, and muscle mass. However, recent consensus has proposed a concern regarding the use of muscle mass measurement for sarcopenia diagnosis due to lack of accuracy; therefore, new assessment methods in clinical practice are required. We compared computed tomography (CT) with various motor function tests to determine the validity of CT as a potential diagnostic method for sarcopenia.MethodsIn total, 214 patients who were examined at our center during the study period (2016–2017) were included in the study. Single-slice CT scan of the mid-thigh region was performed, from which cross-sectional area (CSA) and CT attenuation value (CTV) of quadriceps femoris were evaluated for each subject. Other assessments included skeletal mass index, muscle strength and physical performance. Furthermore, subjects were classified into four groups: normal, low muscle mass (low mass), poor muscle function/strength (poor function), and sarcopenia.ResultsCSA and muscle strength exhibited the strongest correlation. Some physical performance tests showed the strongest correlation with CTV. CSA was significantly reduced both in men and women with low mass and sarcopenia group (p < 0.01), whereas CTV was significantly lower in men with sarcopenia group and in women with poor function and sarcopenia group (p < 0.01).ConclusionsCSA mostly reflects muscle strength, whereas CTV mostly reflects physical performance. CT with measurements of CSA and CTV enables the evaluation of muscle mass and quality simultaneously. Thus, CT is thought to be useful for the assessment of motor function and diagnosis of sarcopenia.

scholarly journals A 3D CNN Classification Model for Accurate Diagnosis of Coronavirus Disease 2019 using Computed Tomography Images

2021 ◽  
Author(s):  
Yifan Li ◽  
Xuan Pei ◽  
Yandong Guo
Keyword(s):  
Computed Tomography ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Classification Model ◽  
Computed Tomography Images ◽  
Image Investigation ◽  
Overall Performance ◽  
3D Cnn ◽  
Ct Slices ◽  
Normal Controls

AbstractThe coronavirus disease (COVID-19) has been spreading rapidly around the world. As of August 25, 2020, 23.719 million people have been infected in many countries. The cumulative death toll exceeds 812,000. Early detection of COVID-19 is essential to provide patients with appropriate medical care and protect uninfected people. Leveraging a large computed tomography (CT) database from 1,112 patients provided by China Consortium of Chest CT Image Investigation (CC-CCII), we investigated multiple solutions in detecting COVID-19 and distinguished it from other common pneumonia (CP) and normal controls. We also compared the performance of different models for complete and segmented CT slices. In particular, we studied the effects of CT-superimposition depths into volumes on the performance of our models. The results show that the optimal model can identify the COVID-19 slices with 99.76% accuracy (99.96% recall, 99.35% precision and 99.65% F1-score). The overall performance for three-way classification obtained 99.24% accuracy and the area under the receiver operating characteristic curve (AUROC) of 0.9986. To the best of our knowledge, our method achieves the highest accuracy and recall with the largest public available COVID-19 CT dataset. Our model can help radiologists and physicians perform rapid diagnosis, especially when the healthcare system is overloaded.

Measuring skeletal muscle mass using C3 cross-sectional computed tomography images

2018 ◽  
Vol 37 ◽  
pp. S37
Author(s):  
B.T. Muresan ◽  
C. Sánchez Juan ◽  
A. Artero ◽  
A. Montoro ◽  
G. Sanchz Jordá ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Skeletal Muscle ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Cross Sectional ◽  
Computed Tomography Images

Loss of Muscle Mass During Chemotherapy Is Predictive for Poor Survival of Patients With Metastatic Colorectal Cancer

2016 ◽  
Vol 34 (12) ◽  
pp. 1339-1344 ◽  
Author(s):  
Susanne Blauwhoff-Buskermolen ◽  
Kathelijn S. Versteeg ◽  
Marian A.E. de van der Schueren ◽  
Nicole R. den Braver ◽  
Johannes Berkhof ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Computed Tomography ◽  
Overall Survival ◽  
Metastatic Colorectal Cancer ◽  
Muscle Mass ◽  
Palliative Chemotherapy ◽  
Survival Rates ◽  
Lumbar Vertebra ◽  
Muscle Loss ◽  
Muscle Area

Purpose Low muscle mass is present in approximately 40% of patients with metastatic colorectal cancer (mCRC) and may be associated with poor outcome. We studied change in skeletal muscle during palliative chemotherapy in patients with mCRC and its association with treatment modifications and overall survival. Patients and Methods In 67 patients with mCRC (mean age ± standard deviation, 66.4 ± 10.6 years; 63% male), muscle area (square centimeters) was assessed using computed tomography scans of the third lumbar vertebra before and during palliative chemotherapy. Treatment modifications resulting from toxicity were evaluated, including delay, dose reduction, or termination of chemotherapy. Multiple regression analyses were performed for the association between change in muscle area and treatment modification and secondly overall survival. Results Muscle area of patients with mCRC decreased significantly during 3 months of chemotherapy by 6.1% (95% CI, −8.4 to −3.8; P < .001). Change in muscle area was not associated with treatment modifications. However, patients with muscle loss during treatment of 9% or more (lowest tertile) had significantly lower survival rates than patients with muscle loss of less than 9% (at 6 months, 33% v 69% of patients alive; at 1 year, 17% v 49% of patients alive; log-rank P = .001). Muscle loss of 9% or more remained independently associated with survival when adjusted for sex, age, baseline lactate dehydrogenase concentration, comorbidity, mono-organ or multiorgan metastases, treatment line, and tumor progression at first evaluation by computed tomography scan (hazard ratio, 4.47; 95% CI, 2.21 to 9.05; P < .001). Conclusion Muscle area decreased significantly during chemotherapy and was independently associated with survival in patients with mCRC. Further clinical evaluation is required to determine whether nutritional interventions and exercise training may preserve muscle area and thereby improve outcome.

scholarly journals Sarcopenia measured with paraspinous muscle using computed tomography for predicting prognosis in elderly pneumonia patients

2021 ◽  
pp. 102490792110418
Author(s):  
Sung Jin Bae ◽  
Keon Kim ◽  
Seong Jong Yun ◽  
Sun Hwa Lee
Keyword(s):  
Computed Tomography ◽  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Muscle Size ◽  
Icu Admission ◽  
Computed Tomography Images ◽  
Prediction Of Mortality ◽  
Paraspinous Muscle ◽  
Receiver Operating

Background: In the elderly, diagnostic findings of pneumonia are often atypical. Computed tomography was recommended for the diagnosis of pneumonia in elderly patients. Recently, the usage of computed tomography as a screening tool for pneumonia in emergency departments has increased. Sarcopenia is defined as the loss of skeletal muscle mass and strength with aging. In this study, the association between sarcopenia and prognosis measured through computed tomography was evaluated compared to CURB-65. Methods: This study was conducted on patients diagnosed with pneumonia through computed tomography from 1 March 2018 to 31 March 2020. The paraspinous muscle size and attenuation were measured at a level located at the T12 pedicle level on axial computed tomography images. Paraspinous muscle size was presented as paraspinous muscle index. Differences in the prognostic performance among the paraspinous muscle size and attenuation, and CURB-65 were evaluated by the area under the receiver operating characteristic curve. Results: A total of 509 patients were included and 132 patients (25.9%) were admitted to the ICU, and 58 patients (11.4%) died in hospital. Paraspinous muscle index was the significant factor for predicting in-hospital mortality and ICU admission. The area under the receiver operating characteristic value of paraspinous muscle index for prediction of mortality was 0.738 and CURB-65 was 0.707. The area under the receiver operating characteristic of paraspinous muscle index and CURB-65 for predicting ICU admission were 0.766 and 0.704, respectively. Conclusion: As a method of measuring sarcopenia, paraspinous muscle index was superior to CURB-65 in elderly pneumonia patients. The use of computed tomography in predicting prognosis for elderly pneumonia patients will ease the economic burden.

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